Mandatory and Must Support Data Elements

The following data-elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each PractitionerRole Must Support:

1. An associated organization
2. An associated practitioner
3. A role
4. A specialty
5. An associated location
6. Contact information
7. A communication endpoint

Profile Specific Implementation Guidance:

• At least one of the following elements must be present:
  • PractitionerRole.practitioner
  • PractitionerRole.organization
  • PractitionerRole.healthcareService
  • PractitionerRole.location
• As a result of implementation feedback, the US Core Location and PractitionerRole Profiles are not explicitly referenced in any US Core Profile. However they SHOULD be used as the default profile if referenced by another US Core profile. See this guidance on Referencing US Core Profiles.
• A Direct address can be represented in the telecom element using the US Core Direct email Extension or in a referenced Endpoint as a “direct-project” endpoint connection type.
• When selecting role codes, implementers SHOULD choose the code that reflects the specific duties performed within that role rather than the specialty unless the individual’s professional specialization characterizes the role.
• Clients can request servers return the Practitioner resource and Endpoint resources by using _include. See Quick Start.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from PractitionerRole

Name	Flags	Card.	Type	Description & Constraints
PractitionerRole	C	0..*	PractitionerRole	Roles/organizations the practitioner is associated with pd-1: SHALL have contact information or a reference to an Endpoint us-core-13: SHALL have a practitioner, an organization, a healthcare service, or a location.
practitioner	SC	0..1	Reference(US Core Practitioner Profile)	Practitioner that is able to provide the defined services for the organization
organization	SC	0..1	Reference(US Core Organization Profile)	Organization where the roles are available
code	S	0..*	CodeableConcept	Roles which this practitioner may perform Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
specialty	S	0..*	CodeableConcept	Specific specialty of the practitioner Binding: Healthcare Provider Taxonomy (extensible)
location	SC	0..*	Reference(Location)	The location(s) at which this practitioner provides care
healthcareService	C	0..*	Reference(HealthcareService)	The list of healthcare services that this worker provides for this role's Organization/Location(s)
telecom	SC	0..*	ContactPoint	Contact details that are specific to the role/location/service
system	S	1..1	code	phone | fax | email | pager | url | sms | other
value	S	1..1	string	The actual contact point details
endpoint	SC	0..*	Reference(Endpoint)	Technical endpoints providing access to services operated for the practitioner with this role
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
PractitionerRole.code	extensible	CareTeamMemberFunction
PractitionerRole.specialty	extensible	HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)

Constraints

Id	Grade	Path(s)	Details	Requirements
pd-1	error	PractitionerRole	SHALL have contact information or a reference to an Endpoint : telecom or endpoint
us-core-13	error	PractitionerRole	SHALL have a practitioner, an organization, a healthcare service, or a location. : practitioner or organization or healthcareService or location

Name	Flags	Card.	Type	Description & Constraints
PractitionerRole	C	0..*	PractitionerRole	Roles/organizations the practitioner is associated with pd-1: SHALL have contact information or a reference to an Endpoint us-core-13: SHALL have a practitioner, an organization, a healthcare service, or a location.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
practitioner	SΣC	0..1	Reference(US Core Practitioner Profile)	Practitioner that is able to provide the defined services for the organization
organization	SΣC	0..1	Reference(US Core Organization Profile)	Organization where the roles are available
code	SΣ	0..*	CodeableConcept	Roles which this practitioner may perform Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
specialty	SΣ	0..*	CodeableConcept	Specific specialty of the practitioner Binding: Healthcare Provider Taxonomy (extensible)
location	SΣC	0..*	Reference(Location)	The location(s) at which this practitioner provides care
healthcareService	C	0..*	Reference(HealthcareService)	The list of healthcare services that this worker provides for this role's Organization/Location(s)
telecom	SΣC	0..*	ContactPoint	Contact details that are specific to the role/location/service
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
endpoint	SC	0..*	Reference(Endpoint)	Technical endpoints providing access to services operated for the practitioner with this role
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
PractitionerRole.code	extensible	CareTeamMemberFunction
PractitionerRole.specialty	extensible	HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
PractitionerRole.telecom.system	required	ContactPointSystem
PractitionerRole.telecom.use	required	ContactPointUse

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	PractitionerRole	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	PractitionerRole	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	PractitionerRole	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	PractitionerRole	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	PractitionerRole	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
pd-1	error	PractitionerRole	SHALL have contact information or a reference to an Endpoint : telecom or endpoint
us-core-13	error	PractitionerRole	SHALL have a practitioner, an organization, a healthcare service, or a location. : practitioner or organization or healthcareService or location

Name	Flags	Card.	Type	Description & Constraints
PractitionerRole	C	0..*	PractitionerRole	Roles/organizations the practitioner is associated with pd-1: SHALL have contact information or a reference to an Endpoint us-core-13: SHALL have a practitioner, an organization, a healthcare service, or a location.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifiers that are specific to a role/location
active	Σ	0..1	boolean	Whether this practitioner role record is in active use
period	Σ	0..1	Period	The period during which the practitioner is authorized to perform in these role(s)
practitioner	SΣC	0..1	Reference(US Core Practitioner Profile)	Practitioner that is able to provide the defined services for the organization
organization	SΣC	0..1	Reference(US Core Organization Profile)	Organization where the roles are available
code	SΣ	0..*	CodeableConcept	Roles which this practitioner may perform Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
specialty	SΣ	0..*	CodeableConcept	Specific specialty of the practitioner Binding: Healthcare Provider Taxonomy (extensible)
location	SΣC	0..*	Reference(Location)	The location(s) at which this practitioner provides care
healthcareService	C	0..*	Reference(HealthcareService)	The list of healthcare services that this worker provides for this role's Organization/Location(s)
telecom	SΣC	0..*	ContactPoint	Contact details that are specific to the role/location/service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
availableTime		0..*	BackboneElement	Times the Service Site is available
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
daysOfWeek		0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required): The days of the week.
allDay		0..1	boolean	Always available? e.g. 24 hour service
availableStartTime		0..1	time	Opening time of day (ignored if allDay = true)
availableEndTime		0..1	time	Closing time of day (ignored if allDay = true)
notAvailable		0..*	BackboneElement	Not available during this time due to provided reason
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
description		1..1	string	Reason presented to the user explaining why time not available
during		0..1	Period	Service not available from this date
availabilityExceptions		0..1	string	Description of availability exceptions
endpoint	SC	0..*	Reference(Endpoint)	Technical endpoints providing access to services operated for the practitioner with this role
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
PractitionerRole.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
PractitionerRole.code	extensible	CareTeamMemberFunction
PractitionerRole.specialty	extensible	HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
PractitionerRole.telecom.system	required	ContactPointSystem
PractitionerRole.telecom.use	required	ContactPointUse
PractitionerRole.availableTime.daysOfWeek	required	DaysOfWeek

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from PractitionerRole

Name	Flags	Card.	Type	Description & Constraints
PractitionerRole	C	0..*	PractitionerRole	Roles/organizations the practitioner is associated with pd-1: SHALL have contact information or a reference to an Endpoint us-core-13: SHALL have a practitioner, an organization, a healthcare service, or a location.
practitioner	SC	0..1	Reference(US Core Practitioner Profile)	Practitioner that is able to provide the defined services for the organization
organization	SC	0..1	Reference(US Core Organization Profile)	Organization where the roles are available
code	S	0..*	CodeableConcept	Roles which this practitioner may perform Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
specialty	S	0..*	CodeableConcept	Specific specialty of the practitioner Binding: Healthcare Provider Taxonomy (extensible)
location	SC	0..*	Reference(Location)	The location(s) at which this practitioner provides care
healthcareService	C	0..*	Reference(HealthcareService)	The list of healthcare services that this worker provides for this role's Organization/Location(s)
telecom	SC	0..*	ContactPoint	Contact details that are specific to the role/location/service
system	S	1..1	code	phone | fax | email | pager | url | sms | other
value	S	1..1	string	The actual contact point details
endpoint	SC	0..*	Reference(Endpoint)	Technical endpoints providing access to services operated for the practitioner with this role
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
PractitionerRole.code	extensible	CareTeamMemberFunction
PractitionerRole.specialty	extensible	HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)

Constraints

Id	Grade	Path(s)	Details	Requirements
pd-1	error	PractitionerRole	SHALL have contact information or a reference to an Endpoint : telecom or endpoint
us-core-13	error	PractitionerRole	SHALL have a practitioner, an organization, a healthcare service, or a location. : practitioner or organization or healthcareService or location

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
PractitionerRole	C	0..*	PractitionerRole	Roles/organizations the practitioner is associated with pd-1: SHALL have contact information or a reference to an Endpoint us-core-13: SHALL have a practitioner, an organization, a healthcare service, or a location.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
practitioner	SΣC	0..1	Reference(US Core Practitioner Profile)	Practitioner that is able to provide the defined services for the organization
organization	SΣC	0..1	Reference(US Core Organization Profile)	Organization where the roles are available
code	SΣ	0..*	CodeableConcept	Roles which this practitioner may perform Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
specialty	SΣ	0..*	CodeableConcept	Specific specialty of the practitioner Binding: Healthcare Provider Taxonomy (extensible)
location	SΣC	0..*	Reference(Location)	The location(s) at which this practitioner provides care
healthcareService	C	0..*	Reference(HealthcareService)	The list of healthcare services that this worker provides for this role's Organization/Location(s)
telecom	SΣC	0..*	ContactPoint	Contact details that are specific to the role/location/service
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
endpoint	SC	0..*	Reference(Endpoint)	Technical endpoints providing access to services operated for the practitioner with this role
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
PractitionerRole.code	extensible	CareTeamMemberFunction
PractitionerRole.specialty	extensible	HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
PractitionerRole.telecom.system	required	ContactPointSystem
PractitionerRole.telecom.use	required	ContactPointUse

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	PractitionerRole	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	PractitionerRole	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	PractitionerRole	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	PractitionerRole	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	PractitionerRole	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
pd-1	error	PractitionerRole	SHALL have contact information or a reference to an Endpoint : telecom or endpoint
us-core-13	error	PractitionerRole	SHALL have a practitioner, an organization, a healthcare service, or a location. : practitioner or organization or healthcareService or location

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
PractitionerRole	C	0..*	PractitionerRole	Roles/organizations the practitioner is associated with pd-1: SHALL have contact information or a reference to an Endpoint us-core-13: SHALL have a practitioner, an organization, a healthcare service, or a location.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifiers that are specific to a role/location
active	Σ	0..1	boolean	Whether this practitioner role record is in active use
period	Σ	0..1	Period	The period during which the practitioner is authorized to perform in these role(s)
practitioner	SΣC	0..1	Reference(US Core Practitioner Profile)	Practitioner that is able to provide the defined services for the organization
organization	SΣC	0..1	Reference(US Core Organization Profile)	Organization where the roles are available
code	SΣ	0..*	CodeableConcept	Roles which this practitioner may perform Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
specialty	SΣ	0..*	CodeableConcept	Specific specialty of the practitioner Binding: Healthcare Provider Taxonomy (extensible)
location	SΣC	0..*	Reference(Location)	The location(s) at which this practitioner provides care
healthcareService	C	0..*	Reference(HealthcareService)	The list of healthcare services that this worker provides for this role's Organization/Location(s)
telecom	SΣC	0..*	ContactPoint	Contact details that are specific to the role/location/service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
availableTime		0..*	BackboneElement	Times the Service Site is available
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
daysOfWeek		0..*	code	mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required): The days of the week.
allDay		0..1	boolean	Always available? e.g. 24 hour service
availableStartTime		0..1	time	Opening time of day (ignored if allDay = true)
availableEndTime		0..1	time	Closing time of day (ignored if allDay = true)
notAvailable		0..*	BackboneElement	Not available during this time due to provided reason
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
description		1..1	string	Reason presented to the user explaining why time not available
during		0..1	Period	Service not available from this date
availabilityExceptions		0..1	string	Description of availability exceptions
endpoint	SC	0..*	Reference(Endpoint)	Technical endpoints providing access to services operated for the practitioner with this role
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
PractitionerRole.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
PractitionerRole.code	extensible	CareTeamMemberFunction
PractitionerRole.specialty	extensible	HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
PractitionerRole.telecom.system	required	ContactPointSystem
PractitionerRole.telecom.use	required	ContactPointUse
PractitionerRole.availableTime.daysOfWeek	required	DaysOfWeek

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from PractitionerRole

Summary

Mandatory: 0 element (2 nested mandatory elements)
Must-Support: 9 elements

Structures

This structure refers to these other structures:

• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

• The syntax used to describe the interactions is described here.

• Servers providing access to practitioner role data can use US Core SMART Scopes for:
  • resource level scopes (for example, patient/PractitionerRole.rs).
• See the General Requirements section for additional rules and expectations when a server requires status parameters.
• See the General Guidance section for additional guidance on searching for multiple patients.

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching practitioner role by specialty using the specialty search parameter:

   • including optional support for these _include parameters: PractitionerRole:endpoint,PractitionerRole:practitioner

   GET [base]/PractitionerRole?specialty={system|}[code]

   Example:

   1. GET [base]/PractitionerRole?specialty=http://nucc.org/provider-taxonomy|208D0000X

   Implementation Notes: Fetches a bundle containing PractitionerRole resources matching the specialty (how to search by token)

2. SHALL support searching practitioner role by practitioner name and identifier using chained parameters using the practitioner search parameter:

   • including support for these chained parameters: practitioner.identifier,practitioner.name
   • including optional support for these _include parameters: PractitionerRole:endpoint,PractitionerRole:practitioner

   GET [base]/PractitionerRole?practitioner={Type/}[id]

   Example:

   1. GET [base]/PractitionerRole?practitioner.identifier=http://hl7.org/fhir/sid/us-npi|97860456&_include=PractitionerRole:practitioner&_include=PractitionerRole?endpoint
   2. GET [base]/PractitionerRole?practitioner.name=Henry&_include=PractitionerRole:practitioner&_include=PractitionerRole?endpoint

   Implementation Notes: Fetches a bundle containing PractitionerRole resources matching the chained parameter practitioner.name or practitioner.identifier.SHOULD support the _include for PractionerRole.practitioner and PractitionerRole.endpoint. (how to search by reference)